My ex-wife had a good death: John Humphrys on why legalising assisted suicide would give people the chance to die peacefully

In the second extract from his new book, John Humphrys explains how, as a former foreign correspondent, he witnessed a great deal of violent death. But sitting with his former wife for her last few hours, watching the sun go down over the Bristol Channel, was the first time he had watched a life end peacefully.

When my former wife, Edna, was diagnosed with pancreatic cancer in her early 50s, I feared for the effect on my daughter Catherine of what would inevitably follow. The bond between mother and daughter is powerful, and they were about as close as it is possible for two human beings to be.

After an exploratory operation, the surgeon told us Edna could expect to live no more than three months. She survived nearly twice as long. In fact, 'survive' is the wrong word; it was more than surviving. She lived those months to the full, and in ways they were good months.

30-year marriage: Newscaster John Humphrys and his ex-wife Edna on their dairy farm in Trelech

As much as anything, that was because of the love and care she had from Catherine, who gave up her career and home in London to move to Wales and be with her mother for as long as it took.

It may not be possible to prove it in a laboratory, but I have not the slightest doubt that love is the most powerful drug for someone facing the final challenge. Those months were not easy for my daughter - a popular, lively young woman in the prime of her life.

There were some bad days and even worse nights, when she would spend the small hours comforting her mother, stroking her back, holding her in her arms. But when death came, Catherine knew her mother was prepared for it, and so was she.

I said that these were, in many ways, good months for Edna. That is not the contradiction it may appear. She knew her cancer could not be beaten, and she refused chemotherapy or any other treatment that might have given her a few extra weeks or months of life.

John and ex-wife Edna with their children Christopher and Catherine

'Why would I want to go through all that and be thoroughly sick and miserable for a year when I can be reasonably fit and active for a few months?' she asked the doctors.

They agreed. She might have added, and sometimes did: 'And when I can use the time to get my life in order.'

Before the cancer struck she had often said that she would like to go on a cruise one day, but when I suggested that she and Catherine should go off on one, she wouldn't hear of it.

She had recently bought an old dairy in the village where she had spent her childhood, and she was determined to finish the job of turning it into a home. Which, of course, she did. She was simply not prepared to die until it was complete and until all her other affairs were 'in order'.

So they were busy months and, yes, they were good months. The Macmillan nurse, who visited regularly, was wonderful. She seemed to have some sixth sense that told her when to call - apparently knowing, wherever she was and whatever she was doing, when Edna needed her most.

Humphrys was the News Journalist of The Year at the Sony
Radio Academy Awards in 2007

There might have been some kind of invisible bond between them. Superstitious nonsense? Probably. But Catherine lost count of the number of times the doorbell would ring when her mother was at a very low point and the nurse would be on the doorstep, always knowing what to do to help.

Macmillan nurses may not be saints, but many do a pretty good impersonation of them. The local cancer hospice - Holme Tower in the Welsh seaside town of Penarth - was wonderful, too. That was where Edna went to die.

Before I visited Holme Tower I could imagine nothing more souldestroying for a doctor or nurse than working in a hospice. Most patients go there to die and you know that, barring miracles that simply do not happen, nothing you can do will change that. The staff never have the joy of seeing a baby born or a sick person get well again.

There is none of the glamour of cuttingedge medicine, none of the drama of a brilliant surgeon transplanting a new lifegiving organ, no prospect of a lucrative Harley Street practice in years to come. I remember asking the doctor who was caring for Edna - a bright and articulate young woman - why she had chosen to practise in a hospice. She seemed genuinely puzzled by the question.

'It's incredibly satisfying,' she said. 'The job of a doctor isn't just curing people, it's reducing suffering. That's what we do here. We help people die at peace and in dignity. I can't think of anything more rewarding.'

She paused and then added: 'It means so much. It's a wonderful job.'

I know how corny those words look when they're written down, but they didn't seem corny to me at the time and they don't seem corny now. A few weeks later, I had the privilege of watching them put into practice.

I was in the BBC Westminster offices on a Saturday morning preparing for the On The Record programme that I had presented every Sunday for almost ten years. Catherine called to say that the end was near, and I drove down to Penarth.

When I arrived, Edna had only a few hours left. I sat in her large room overlooking the grey waters of the Bristol Channel as the sun went down.

I had seen a great deal of violent death in my years as a foreign correspondent, but that was the first time I had watched a life ending peacefully. She was breathing deeply and easily.

RELATED ARTICLES

Share this article

Share

The occasional sigh escaping from her lips was the only thing to suggest that this was more than just a deep sleep. The room was almost dark when a nurse slipped quietly in through the half-open door. I said nothing and I don't think she saw see me in the corner, almost hidden as I was by a half-drawn curtain around Edna's bed.

She stood for several minutes looking down at the dying woman. Then she leaned over and stroked her hair, as gently as a mother might caress a sleeping baby. And then she left again. There was nothing else to be done, nothing else she could have done. Before the sun rose again Edna was dead.

Technically, I was told, she was killed not by the cancer but by the drugs. The dose was steadily increased to keep one step ahead of the pain, until eventually her heart gave out.

She died - as the young doctor had promised - in peace and with dignity. The doctor might have added something else: she died surrounded by love.

Some time after Edna's death I wrote an article about how her morphine had been increased until it killed her, basing my comments on what I was told at the time by nurses and doctors. It caused a most extraordinary reaction. I'd been assured by medical staff that they would never allow a patient to suffer, and that increasing a morphine dose to a fatal level was an accepted procedure.

That seemed to me to be eminently sensible and humane, and I wrote the same after my father's death six years later, in 2003. So I was puzzled and upset when I received letters from several doctors - including experienced consultants - challenging what I had written.

One consultant told me that he had worked in three hospice units and two cancer centres and with three Macmillan community teams - and had never seen it done. So what is going on here? The answer lies in something called the 'doctrine of double effect'.

Most of us have never heard of it and there is no reason why we should have done.

What it means is that a doctor can give a patient drugs that may kill him - but only so long as he is doing it to relieve that patient's pain. That seems pretty straightforward. It's not - it's an ethical quagmire. The strongest painkillers we have in this country are called the opioids, which include morphine and diamorphine, otherwise known as heroin.

Now, as we all know, it is impossible to read a newspaper or watch a television crime programme without being aware that an overdose of heroin can kill you. It happens tragically often. But in the right dose these drugs are often the only way of controlling the pain of someone who is in the last stages of illness.

About four out of five people dying in hospices are given morphine in the last few days of their lives. How our bodies react to a drug depends on all sorts of things - our age, our weight or any other drugs we might be taking at the time. Our pain threshold is another important factor. If we have a low threshold of pain it's obvious that we will need a bigger dose than if we have a high one.

So pain relief always involves a certain amount of trial and error.

A sensible doctor will start with the minimum dose and increase it gradually until the pain is gone. So far, so good. It involves no ethical issues - just sensible treatment. But the problems arise when the pain is so great that a massive dose is needed - one that is likely to stop the patient breathing. The doctor knows that if he continues to increase the dose the patient will die. To put it more bluntly: the doctor will have killed the patient.

The most recent studies suggest this does not happen often, but it is impossible to put even a roughly accurate figure on it for obvious reasons. When people are in the terminal stages of a terrible illness such as liver cancer they will die whatever the doctor does.

Sometimes the doctor genuinely will not know whether it was the diamorphine or the illness that stopped the heart, so the doubt is always there. Short of rewinding time and giving the patient exactly the same treatment without the morphine, the doctor cannot possibly be certain which one caused death. What many believe is that without the medicine the patient would not have had a longer life in any meaningful sense of the word - just the wretched prospect of a longer death. Hence the doctrine of double effect. It says to the doctor: it is possible that you may kill a patient, but if you have done so in the process of trying to relieve suffering you cannot be held to account.

That, you might think, is all the reassurance a doctor needs to do what he believes is in the best interests of the patient. Not so. As one put it, the great fear for a doctor who is trying to relieve the patient's pain is not that he might kill him by accident. It is that those left behind will believe that he killed him on purpose. This is more than paranoia on the part of doctors.

Even though they can call on the doctrine of double effect to justify their actions, there is always the fear they might possibly be charged with manslaughter or even murder. It has happened several times in living memory, most recently in 1999, when a Northumberland GP, David Moor, was charged with murder after he had given diamorphine to a terminally ill patient. What made his case different was that he had agreed to be interviewed by a Sunday newspaper.

The interview was published the day after the patient died. In it, Dr Moor admitted he had given many of his patients diamorphine to help them have a pain-free death. 'I address the problem and the needs of the patient with care and compassion,' he'd said.

The case went to court, but he was eventually acquitted. But the controversy remained. In the aftermath of the trial, the broadcaster Ludovic Kennedy commented: 'Dr Moor should never have been tried - the whole trial was a complete waste of time and money.

'He was only doing what hundreds and hundreds of doctors do in this country every year. The sooner the law is changed to allow doctors to legally help people on their way, the better.'

And Dr Michael Wilks, chairman of the BMA's ethics committee, spoke after the case about the lack of clear guidelines for doctors. 'We are no further along the road towards any change in the law on euthanasia,' he said.

'This case just tells us that doctors who take the law into their own hands, who intend to kill their patients, as it was originally thought Dr Moor had, are likely to be prosecuted.'

Is it any wonder that this entire subject is surrounded with contradictions and confusion?

If you had asked me when I was a brash young man, for whom dying was no more than a vague theoretical concept, to define 'a good death' I'd have summed it up in one word - 'quick'.

I might have prefaced it with 'mercifully'. Don't we all want death to come when we're looking the other way? An enjoyable evening out with friends - strolling home and sharing a laugh - then keeling over. And that's that. Dead of a heart-attack before you hit the pavement. Or, even better, going to bed one night after a pleasant dinner with the person you love most in all the world and simply not waking up in the morning. Perfect. No pain. No months spent in hospital waiting for the inevitable.

No crippling stroke that leaves you reliant on others for everything. Robbed of independence. Robbed of dignity. Above all, perhaps, desperately scared. A sudden death must surely be an infinitely preferable alternative to this, I'd always thought. That's what I had always wanted for myself in those infrequent, but morbid moments when I contemplated my own mortality.

But I now think I was wrong. It might be perfect for the person who does not wake up in the morning, but it is a savage blow to the loved one left behind. A 'good death' has, I believe, to be 'good' at a very deep level for friends and families, too. That truly extraordinary woman and founder of the modern hospice movement, Dame Cicely Saunders, once said: 'We will do all we can not only to help you die peacefully, but to help you live until you die.'

This is what happened for Edna, and I so wish it could have happened for my beloved younger brother and best friend Rob, who died last summer in his 50s within weeks of being diagnosed with lung cancer. It didn't, and eight months later I still believe, as I will describe tomorrow, that in his death he was betrayed, not only by the system, but also by me.